Emergencies in the Backcountry

If you have an emergency in the backcountry, the most important thing to remember is to stay calm. Use your head, create a plan, and seek help.

Backcountry Health Concerns:

Sunburn

Causes: Skin gets exposed to excessive UV light from the sun. A common problem in the outdoors, during any season, even possible in cloudy conditions.

Prevention: Wear sunscreen with SPF 30 or more. Katie and Mark choose Sawyer Stay Put Sunscreen Lotion with SPF 50. Minimize your exposure to the sun, especially during mid-day. Shade your head, neck, and ears, and check frequently for signs of sunburn. Wear sunglasses that offer UV protection. Wear lip balm with UV protection. Make sure you are not taking medications that increase your risk of sunburn and don’t use facial products that increase your risk of sunburn.

Treatment: If you get burned, use an aloe-based skin cream on the affected areas.  Do not allow those areas to be exposed to sun for the rest of your trip.  If sunburn is serious, or if you experience symptoms such as nausea, chills, or fever, seek professional medical attention as soon as possible.

Blisters

Causes: Friction rubbing your skin in a particular area causes blisters to form. They are easier to avoid than they are to fix.

Prevention: Wear footwear that fits properly and is broken in.  Wear clean socks that fit properly. Consider wearing two pairs of socks. On the trail, check frequently for signs of discomfort and address them immediately. Know how to us blister prevention and treatment items (which should be in your first aid kit) such as moleskin or 2nd skin. Consider applying moleskin or 2nd skin to your blister-prone areas before you even begin your hike. Be vigilant to the presence of blisters.

Treatment: If a blister becomes too painful, you can drain it using a clean razor blade or knife. Make sure you know exactly how to do this before attempting. We are not going to get into the details here. Once you have lanced the blister, apply antibacterial ointment and cover the area with one of your blister treatment options.

Poison Ivy, Poison Oak, and Poison Sumac

Causes: These plants cause irritating reactions when contacted. Some reactions may be more severe than others, and some people are more susceptible to reactions than others.

Prevention: Know how to identify these plants. Just knowing how the leaves look is insufficient, because contact with poison ivy, even when the leaves have fallen off, can still cause irritation.  In general, refrain from touching plants you can’t identify, and stay out of thick brush if it can be avoided. Stick to the trail and don’t burn anything green in your campfire.

Treatment: Apply hydrocortisone cream to the affected area. Clean your clothing and boots to avoid spreading the reaction to other areas of your body or to other people. Consult your first aid manual or a health care provider. If you believe you have a serious medical condition, seek professional attention as soon as possible.

Biting Insects

Causes: Bites from mosquitos, flies, or other insects are common in nature. Insects can carry diseases. Spider bites can be a concern too, but most spiders are harmless.

Prevention: Don’t venture or camp in areas where biting insects are most heavily concentrated. This means avoiding standing water, swamps and bogs, some riverbanks and ponds, etc. Wear appropriate clothing, don’t wear perfume or cologne, or perfumed deodorants, lotions, or lip balms. Use insect repellant if necessary. Treat clothing and gear with permethrin before leaving.

Treatment: If you are allergic to insect bites or stings, consult with your health care provider before leaving to determine what medications you need to bring. Let everyone in your group know about your allergy and what to do if you have an allergic reaction. First aid products that reduce inflammation and irritation are affective treatments against insect bites. If a spider bites you, monitor the bite site and your personal condition. If you expect you have been bitten by a poisonous spider (black widow, brown recluse, etc.), seek medical attention.

Stinging Insects

Causes: Stings from bees, wasps, yellow jackets, and hornets. Stings can be dangerous and even life-threatening if you are allergic or if you get stung several times.

Prevention: “If the bush is buzzing, turn the other way”. It seems like common sense, but often you will have to remind people in your group to leave an area quickly if a known hive is around. Try not to wear brightly-colored clothing, shiny jewelry, or perfumes/colognes as these may attract stinging insects.

Treatment: Use first aid items for stings. Remove the stinger (carefully) if it is still in place. Use an oral antihistamine (Benadryl). Epinephrine if you are allergic. If you have an allergic reaction to a stinging insect, seek professional medical attention as soon as possible – some allergic reactions can be life-threatening. Always have physician-recommended medication with you if you know you are allergic, and make sure your group knows that you are allergic and what to do in the event of a reaction.

Ticks

Causes: Ticks are a common issue in the wilderness. There are many different types of ticks and some transmit diseases such as Lyme disease or tick fever. Ticks get on your clothing or gear from plants, trees, animals, and even the ground, and make their way to your skin where they will seek a blood meal. Ticks transmit disease when they bite and burrow into your skin. They cannot transmit disease by merely touching you.

Prevention: Avoid areas where ticks are most likely to be. These include dense vegetation, certain areas of parks, certain species of trees, tall grass, etc. Consult with local rangers to determine risk of ticks in that area. Check your skin every day, twice a day, for ticks. Pay special attention to areas like your hair, behind your ears, in your armpits, your groin area, and your backside. Ticks will find their way anywhere they can.

Treatment: If you find a tick, you will need to remove it. This can be done using tweezers if the tick has not burrowed into your skin. Always disinfect the area after removing a tick. Check for signs of Lyme disease or tick fever after you know a tick has bitten you. Tell your doctor as soon as possible if you notice any symptoms of these diseases.

Snakes

Causes: Most snake bites are not deadly, but some can be. Certain species of snakes carry venom, which can cause lethal reactions in humans and other animals. All snakes can transmit infections from biting.

Prevention: Avoid areas where snakes are most prevalent. Consult with a local ranger to identify high-risk areas and mark those on your map and waypoints (see Planning section documents for examples of how Katie and I do this). Tell everyone in your group about snake risk areas and know what species of snakes you may encounter. Talk with experiences wilderness travelers and backpackers about how to avoid snakes and snake bites. Never approach a snake, try to move a snake, or try to kill a snake. If you hear rattling, back away slowly. While some snakes are aggressive, most will only bite if provoked or scared. They are much more scared of you than you are of them. Think about it; if you were a snake and saw a giant walking towards you, you’d bite too. That has to be terrifying.

Treatment: If a snake bites you, stay calm and keep everyone else calm. Do not move the limb where the bite occurred, and do not attempt to apply compression.  Get to a physician as soon as possible. Remember, most snakes are not venomous and most venomous snake bites are not fatal. Be smart and leave the treatment to the professionals. Katie and Mark carry a snake bite kit (recommended in Dr. William Forgey’s Wilderness Medicine) to treat our own snake bites, but keep in mind Katie is a professional health care provider. If you are not a health care provider, it is best to seek medical help without attempting to treat your own injury as your “treatment” may cause additional damage and put you at risk of a more serious condition.

Emergency Situations and How to Avoid Them

(Wilderness Safety, US National Park Service, http://www.nps.gov/olym/planyourvisit/wilderness-safety.htm)

Stream Crossings

Drowning or serious injury can occur with improper stream crossing. Find the best crossing point by identifying a wider, shallower area with favorable conditions down stream. Unbuckle your pack straps so you can escape your pack if you fall, and angle your travel across the current. Never tie yourself in while you cross. When in doubt, do not cross.

Hypothermia

Hypothermia is known by many as the number one killer in the backcountry. It is caused by the cooling of your body. Do not wear cotton. Instead, wear wool or synthetic layers to prevent hypothermia. Stay dry and do not work yourself into a sweat, as this may cause the cooling of your body. You can get hypothermia in all seasons, not just in winter. Know the symptoms of hypothermia (poor judgment, lethargy, shivering, clumsiness) and be vigilant for these symptoms in your group. Hypothermia can be deadly, and you need to take staying warm and dry seriously to be a backpacker. If hypothermia is expected, prevent further heat loss and rewarm and rehydrate the victim.

Dehydration

You need water to survive, period. Know how to stay hydrated, make sure you are bringing enough water, and know how to acquire and filter more water when needed.

Injuries

Injuries occur during wilderness travel, even if you are prepared. If this happens to you or someone in your group, you need to know what to do. First, provide whatever treatment you can. We are lucky because Katie is a health care professional, and we’re both trained in first aid. If you are not trained, it is a good idea to become familiar with some basic first aid and injury treatment techniques before embarking on your adventure. At least one person in every group should know first aid and CPR. After applying treatment, seek help. The National Park Service recommends you send for help with the following information:

• Nature of the emergency: date and time it occurred, details of incident and injuries.

• Patient condition: airway, breathing and circulation—normal or on the extreme? Has first aid been given? Is CPR in progress?

• Location: the closest known location, or approximate distance or walking time from a known location. Mark it on your topo map as best you can.

• Resources: number of people (adult/juvenile) and equipment left at the scene.

• Patient information: name, address, phone, age, weight, who to notify.

• Color of injured party's belongings: tent, pack, clothing

Getting Lost

If you become lost, the National Park Service recommends the following protocol: “If you become lost, turn to your Ten Essentials. Stay calm and think through the situation. Stay put—you will be found sooner. Stay warm and dry. If you are tempted to follow a river or creek, remember that these are often the most dangerous routes...Create a signal visible from the air. Lay out brightly-colored clothing in a forest clearing. Use a signal mirror.

To report emergencies, (such as overdue hikers or injuries) dial 911, or the number of the park rangers/park emergency line.

Ask about the location of park ranger stations and know where the closest help is at various points on your route before you go.

Remember to stay calm and assess your situation. The worst thing that can happen in an emergency is creating a worse situation by panicing or acting without thinking.